scholarly journals Factors affecting bone maturation in Chinese girls aged 4–8 years with isolated premature thelarche

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Huiping Su ◽  
Zhe Su ◽  
Lili Pan ◽  
Li Wang ◽  
Zhongwei Xu ◽  
...  
Keyword(s):  
Bone Maturation ◽  
Premature Thelarche ◽  
Factors Affecting ◽  
Isolated Premature Thelarche ◽  
Chinese Girls

scholarly journals Factors affecting bone maturation in 423 Chinese girls aged 4-8 years with isolated premature thelarche

2020 ◽  
Author(s):  
Huiping Su ◽  
Zhe Su ◽  
Lili Pan ◽  
Li Wang ◽  
Zhongwei Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Standard Deviation Score ◽  
Multiple Linear Regression Model ◽  
Normal Weight ◽  
Sex Hormone Binding Globulin ◽  
Bone Maturation ◽  
Premature Thelarche ◽  
Independent Risk Factors ◽  
Isolated Premature Thelarche ◽  
Chinese Girls

Abstract Background: In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age, but IPT girls requiring further investigations show another trend. We analysed BA and possible potentiating factors in girls aged 4-8 years with IPT. Methods: IPT girls aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were divided into two groups with advanced BA of 2 years as the cutoff. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups seperately according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS to compare BA. Results: Overall, 423 subjects were classified into the advanced BA (48.7%, n=206) and control groups (51.3%, n=217). The advanced BA group had significantly higher BMI SDS, DHEAS SDS, IGF-1 SDS, androstenedione and serum fasting insulin and significantly lower sex hormone binding globulin (all p<0.001). IGF-1 SDS (OR=1.642, p＜0.001) and DHEAS SDS (OR=1.125, p=0.021) were independent risk factors for advanced BA. In the multiple linear regression model, IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 18.9% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n=237 ), overweight (19.15%, n=81) and obesity (24.82%, n=105). The proportion of BA advancement in obesity was significantly higher than that of normal weight (χ2=18.088, P＜0.001). In a subgroup with normal weight, higher IGF-1 SDS (p=0.009) and DHEAS SDS (p=0.003) affect BA advancement independent of BMI SDS. Conclusions: Chinese girls aged 4-8 years with IPT requiring further investigations might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.

scholarly journals Factors affecting bone maturation in Chinese girls aged 4-8 years with isolated premature thelarche

2020 ◽  
Author(s):  
Huiping Su ◽  
Zhe Su ◽  
Lili Pan ◽  
Li Wang ◽  
Zhongwei Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Standard Deviation Score ◽  
Multiple Linear Regression Model ◽  
Normal Weight ◽  
Stimulation Test ◽  
Sex Hormone Binding Globulin ◽  
Bone Maturation ◽  
Premature Thelarche ◽  
Independent Risk Factors ◽  
Isolated Premature Thelarche

Abstract Background: In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age. However, IPT girls confirmed by gonadotropin-releasing hormone (GnRH) stimulation test could show another trend. We analysed BA and possible potentiating factors in girls aged 4-8 years with IPT.Methods: IPT girls aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were divided into two groups with advanced BA of 2 years as the cut-off. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups separately according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS to compare BA.Results: Overall, 423 subjects were classified into the advanced BA (48.7%, n=206) and control groups (51.3%, n=217). The advanced BA group had significantly higher BMI SDS, DHEAS SDS, IGF-1 SDS, androstenedione and serum fasting insulin and significantly lower sex hormone binding globulin (all p<0.001). IGF-1 SDS (OR=1.926, p＜0.001), BMI SDS (OR=1.427, p=0.001) and DHEAS SDS (OR=1.131, p=0.005) were independent risk factors for advanced BA. In the multiple linear regression model, IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 19.3% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n=237 ), overweight (19.15%, n=81) and obesity (24.82%, n=105). The proportion of advanced BA in obesity was significantly higher than that of normal weight and overweight (χ2=18.088, P＜0.001). In a subgroup with normal weight, higher IGF-1 SDS (p=0.009) and DHEAS SDS (p=0.003) affected BA advancement independent of BMI SDS. Conclusions: Girls with IPT confirmed by GnRH stimulation test aged 4-8 years might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.

scholarly journals Factors affecting bone maturation in Chinese girls aged 4-8 years with isolated premature thelarche

2020 ◽  
Author(s):  
Huiping Su ◽  
Zhe Su ◽  
Lili Pan ◽  
Li Wang ◽  
Zhongwei Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Standard Deviation Score ◽  
Multiple Linear Regression Model ◽  
Normal Weight ◽  
Stimulation Test ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Premature Thelarche ◽  
Independent Risk Factors ◽  
Isolated Premature Thelarche

Abstract Background: In isolated premature thelarche (IPT) girls, bone age (BA) is considered consistent with chronological age. However, some IPT girls confirmed by gonadotropin-releasing hormone (GnRH) stimulation test could show another trend. We analysed BA and possible potentiating factors in a selected group of girls aged 4-8 years with IPT. Methods: IPT girls confirmed by GnRH stimulation test aged 4-8 years hospitalized from January 2015 to April 2018 at Shenzhen Children's Hospital were included in this retrospective study. They were divided into two groups with advanced BA of 2 years as the cut-off. Body mass index (BMI) and hormone levels were the main outcome measures, and regression analysis was used to identify independent risk factors. IPT girls were divided into subgroups according to the levels of BMI standard deviation score (SDS), insulin-like growth factor-1 (IGF-1) SDS and dehydroepiandrosterone sulfate (DHEAS) SDS for comparisons of advanced BA. Results: Overall, 423 subjects were included and classified into the advanced BA group (48.7%, n=206) and control group (51.3%, n=217). The advanced BA group had significantly higher BMI SDS, serum DHEAS SDS, IGF-1 SDS, androstenedione and fasting insulin and significantly lower sex hormone binding globulin (all p<0.001). Serum IGF-1 SDS (OR=1.926, p＜0.001), BMI SDS (OR=1.427, p=0.001) and DHEAS SDS (OR=1.131, p=0.005) were independent risk factors for significantly advanced BA. In the multiple linear regression model, serum IGF-1 SDS, BMI SDS and DHEAS SDS were the strongest predictors of advanced BA, accounting for 19.3% of the variance. According to BMI, 423 patients were classified into three groups: normal weight (56.03%, n=237), overweight (19.15%, n=81) and obesity (24.82%, n=105). The proportion of advanced BA in obesity group was significantly higher than those of normal weight and overweight groups (χ2=18.088, p＜0.001). In the subgroup with normal weight, higher serum IGF-1 SDS (p=0.009) and DHEAS SDS (p=0.003) affected BA advancement independent of BMI SDS. Conclusions: Girls with IPT confirmed by GnRH stimulation test aged 4-8 years might have significantly advanced BA. Obesity was highly associated with advanced BA. Age-specific serum IGF-1 SDS and DHEAS SDS were risk factors for BA advancement independent of BMI.

GROWTH DISTURBANCES AND VALUES FOR HORMONE EXCRETION IN VARIOUS FORMS OF PRECOCIOUS SEXUAL DEVELOPMENT

PEDIATRICS ◽  
1961 ◽  
Vol 28 (2) ◽  
pp. 258-275
Author(s):  
Pierre Ferrier ◽  
Thomas H. Shepard ◽  
Elizabeth Knapp Smith
Keyword(s):  
Precocious Puberty ◽  
Sexual Development ◽  
Laboratory Finding ◽  
Vaginal Smear ◽  
Bone Maturation ◽  
Premature Thelarche ◽  
Sexual Precocity ◽  
Premature Adrenarche ◽  
Primordial Dwarfism ◽  
Hormone Excretion

Forty-two children with precocious sexual development have been classified according to: a) constitutional sexual precocity, b) premature adrenarche, and c) premature thelarche. Constitutional sexual precocity and premature adrenarche are associated with excessive growth, advance in bone maturation, and elevation of the urinary 17-ketosteroids. In contrast, in premature thelarche growth, bone maturation and 17-ketosteroids were normal. The presence of estrogenization of the vaginal smear was the most helpful laboratory finding in differentiating constitutional sexual precocity from the other two conditions. The presence of detectable urinary gonadotropins in precocious puberty is of limited help. Two patients with primordial dwarfism and associated precocious puberty are reported. The occurrence of constitutional precocious puberty in a brother and a sister is described. This is apparently the first reported instance in which familial precocious puberty occurs in either sex.

scholarly journals Premature thelarche: identification of clinical and laboratory data for the diagnosis of precocious puberty

2002 ◽  
Vol 57 (2) ◽  
pp. 49-54 ◽  
Author(s):  
Thais Della Manna ◽  
Nuvarte Setian ◽  
Durval Damiani ◽  
Hilton Kuperman ◽  
Vaê Dichtchekenian
Keyword(s):  
Luteinizing Hormone ◽  
Precocious Puberty ◽  
Follicle Stimulating Hormone ◽  
Bone Age ◽  
Premature Thelarche ◽  
Luteinizing Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Hormone Stimulation ◽  
Isolated Premature Thelarche ◽  
Stimulating Hormone

PURPOSE: Two groups of girls with premature breast development were studied retrospectively. We tried to identify clinical, radiological, and hormonal parameters that could distinguish between a benign, nonprogressive premature thelarche and a true precocious puberty. METHODS: The clinical outcome of 88 girls with breast enlargement before 6.1 years of age was analyzed. Taking into account the progression of their sexual maturation, we allocated the children into 2 groups: "Isolated Premature Thelarche" (n = 63) and "Precocious Puberty" (n = 25) groups. Chronological and bone ages, height and growth velocity centiles, computerized tomography of hypothalamus-pituitary area, pelvic ultrasonography, gonadotropin response to luteinizing hormone-releasing hormone stimulation as well as basal levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and prolactin were studied in both groups. Statistical analysis were performed using the Student t test to compare the sample means. Fisher's exact test and chi² test were used to analyze the nonparametric variables. RESULTS: Isolated premature thelarche most frequently affected girls younger than 2 years who presented exaggerated follicle-stimulating hormone response to luteinizing hormone-releasing hormone stimulation test. The precocious puberty group had higher initial stature, accelerated growth rate and bone age, increased uterine and ovarian volumes, high spontaneous luteinizing hormone levels by immunofluorimetric assay, as well as a high luteinizing hormone response and peak luteinizing hormone/follicle-stimulating hormone ratio after luteinizing hormone-releasing hormone stimulation. CONCLUSION: At initial presentation, girls who undergo true precocious puberty present advanced bone age, increased uterine and ovarian volumes in addition to breast enlargement, as well as an luteinizing hormone-predominant response after a luteinizing hormone-releasing hormone stimulation test.

Fluctuation of Breast Size in Isolated Premature Thelarche

1985 ◽  
Vol 74 (3) ◽  
pp. 454-455 ◽  
Author(s):  
R. Stanhope ◽  
J. Adams ◽  
C. G. D. Brook
Keyword(s):  
Breast Size ◽  
Premature Thelarche ◽  
Isolated Premature Thelarche

Thelarche variant: A new syndrome of precocious sexual maturation?

1990 ◽  
Vol 123 (5) ◽  
pp. 481-486 ◽  
Author(s):  
Richard Stanhope ◽  
Charles C. D. Brook
Keyword(s):  
Precocious Puberty ◽  
Sexual Maturation ◽  
Central Precocious Puberty ◽  
Clinical Findings ◽  
Breast Development ◽  
Gnrh Analogue ◽  
Gonadotropin Secretion ◽  
Premature Thelarche ◽  
Isolated Premature Thelarche ◽  
Depot Injections

Abstract. We describe 10 girls (mean age 3.7 years, range 1.9-6.9) with precocious sexual maturation and clinical findings intermediate between those of premature thelarche and central precocious puberty. Studies of spontaneous gonadotropin secretion and ovarian ultrasound morphology also revealed findings intermediate between those of isolated premature thelarche and central precocious puberty. There was no response in 6 of the girls treated with GnRH analogue, whether administered intranasally, sc, or by monthly depot injections. We have called this condition thelarche variant because the gonadotropin independence and cyclical nature of breast development may well be due to a lesion of folliculogenesis.

scholarly journals Premature thelarche: clinical and laboratorial assessment by immunochemiluminescent assay

2008 ◽  
Vol 52 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Maria F. Borges ◽  
Kátia D. Pacheco ◽  
Andréia A. Oliveira ◽  
Cláudia V. C. Rita ◽  
Karla D. Pacheco ◽  
...  
Keyword(s):  
Precocious Puberty ◽  
Stimulation Test ◽  
Serum Concentrations ◽  
Control Groups ◽  
Premature Thelarche ◽  
Isolated Premature Thelarche ◽  
Peak Value

In order to establish cut-off limits and to distinguish isolated premature thelarche (IPT) from precocious puberty (PP), we evaluated data from 79 girls with premature thelarche, comparing basal and stimulated LH and FSH serum concentrations with those from 91 healthy girls. A GnRH stimulation test was performed in 10 normal girls and in 42 with premature thelarche. Comparison among groups was performed by Kruskal-Wallis and Dunn’s tests. LH values were significantly greater in girls with IPT than in control groups. Basal gonadotropin concentrations were higher in patients with PP than in controls, but not different from patients with IPT. Peak LH levels after GnRH stimulation distinguished those two groups, with a cut-off value of 4.0 IU/L, but still with minimal overlap. In conclusion, a girl with premature thelarche and LH peak value above 4.5 IU/L has, indeed, PP, but values between 3.5 and 4.5 IU/L point to careful follow-up.

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